Symptom appraisal of potential lung cancer symptoms in people with Chronic Obstructive Pulmonary Disease


Session type:


Katie Robb1,Yvonne Cunninghamm1,Una Macleod2,Sara Macdonald1,Jo Waller3,Stephen Harrow4,Sally Wyke1,Katriina Whitaker5
1University of Glasgow,2Hull Medical School,3University College London,4NHS Greater Glasgow and Clyde,5University of Surrey



For people with Chronic Obstructive Pulmonary Disease (COPD), incidence of lung cancer is four times higher than those without COPD. Promoting a shorter time to presentation is considered one key strategy for achieving earlier diagnosis of lung cancer and improving survival. The aim was to explore how the experience of COPD influences symptom appraisal and help-seeking for potential lung cancer symptoms.


Qualitative interviews were conducted with men (n=17) and women (n=23) aged 40-83 with a diagnosis of COPD. Topic guides drew on the Integrated Symptom-Response Framework and asked about experience and interpretation, action, symptom recognition and help-seeking, evaluation and re-evaluation.  Framework Analysis was used to interpret the data.


Participants tended to attribute all their (chest) symptoms to their COPD, and it did not occur to them that a change in symptoms could have a cause other than COPD. Most participants talked about how friends/family would notice a change in their symptoms and encourage help-seeking.  However, others felt their COPD isolated them due to lack of mobility, fatigue, perceived disgust and embarrassment.  Participants tended to visit health professionals frequently, however there was a lack of awareness of their increased risk of lung cancer.


People with Chronic Obstructive Pulmonary Disease (COPD) tended to attribute all symptoms to their COPD and were unaware that they were at increased risk of lung cancer. Family and friends could notice changes in symptoms however some participants reported social isolation.